Frequency of Appropriate and Low-Risk Noncardiac Preoperative Stress Testing Across Medical Specialties.

Preoperative stress testing in asymptomatic patients is considered rarely appropriate in patients with: (1) moderate to good functional capacity (≥4 metabolic equivalent (METs)), (2) no clinical risk factors, or who are (3) asymptomatic after revascularization, normal stress test, or normal coronary angiography within 1 year. Preoperative stress testing is also not recommended in patients at low risk (<1%) for adverse cardiac events. We investigated the frequency of rarely appropriate and low-risk preoperative stress testing across medical specialties at our institution in asymptomatic patients when applying appropriate use criteria and two different perioperative risk models.

Screening for psychological distress in surgical breast cancer patients.

Background: This pilot study assessed the levels of patient emotional distress and impact on clinic throughput time.

Methods: From April through August 2012, 149 breast cancer patients at the Penn State Hershey Breast Center were screened with the emotions thermometer (ET), a patient-rated visual 0-10 scale that measures distress, anxiety, depression, anger, burden, and need for help. Also, patients indicated their most pressing cancer-related concerns.